The director of the U.S. Disaster Assistance Center in Pakistan says aid is pouring into areas devastated by this month's earthquake, but tough terrain and landslides are making delivery difficult in remote regions. Navy Rear Admiral Michael LeFever briefed reporters in Washington via telephone from Islamabad.

Admiral LeFever told reporters at the Pentagon nearly two million tons of supplies have been delivered to Pakistan's Kashmir region and more than 1,000 U.S. military personnel will soon be involved in rescue and relief efforts

The U.S. military hopes to have at least 25 helicopters operating shortly to bring in materials and evacuate thousands of wounded.

Admiral LeFever says the mountainous environment makes such work difficult.

"On the ground an incredible scene, it is very rugged terrain," he said. "We are here at 1,600 feet in Islamabad. The elevation rapidly grows to 6,000 and 8,000 feet elevation. Narrow roads along river valleys and some of these river valleys are secondary lines of communication that cutoff many regions and we are in support of the government of Pakistan in clearing those roads, clearing the rubble to open up the lines because we know it is just not a helicopter mission."

Admiral LeFever says a Mobile Army Surgical Hospital (MASH) has just arrived in Kashmir, while the Navy ship U.S.S. Pearl Harbor has docked in the port city of Karachi, bringing food and blankets donated by Pakistani nationals in the United Arab Emirates.

The head of the U.S. relief operation says everything from very basic to sophisticated transportation methods are being used to deliver aid.

"In some areas we have seen the mule trains head up into the hills to provide supplies to the really remote villages," he added. "Tomorrow we start C-130 drops, air drops of supplies at the request of the government of Pakistan to areas that are very remote, to be able to get some bulk supplies into those regions that are particularly packaged with food, blankets, tents and medical supplies for the areas."

The United Nations is warning that hundreds of thousands of people are still without shelter and greater relief efforts are needed before the arrival of winter.

Admiral LeFever says there is no doubt international help will be needed for many years.

"My initial assessment is there is quite a bit of devastation and this is not a quick, immediate kind of the 9-1-1s (quick emergencies) that everybody provides, but it is going to be a very long term rehab and reconstruction in these areas and it will require continued international support, probably for years to come."

The October 8 quake is believed to have killed more than 53,000 people in Pakistan and about 1,300 in Indian Kashmir.

Admiral LeFever says Pakistan has stood by the United States in the war on terror and the U.S. military is committed to helping the quake victims for a long period of time.